Maintenance fluid practices in paediatric intensive care units in Australia and New Zealand.

BACKGROUND: Maintenance fluid administration is a common practice in paediatric intensive care units (PICUs), contributing to daily fluid intake and fluid balance, but little is known about this practice.

OBJECTIVES: To determine the volume and type of maintenance fluid delivered to PICU patients, and to assess changes in practice compared with a previous time point.

METHODS: A prospective, observational, single-day, point prevalence study of paediatric patients from 11 Australian and New Zealand PICUs, conducted in 2014.

RESULTS: Seventy-two patients were enrolled. The median age and weight of infants aged < 1 year (n = 34) were 2 months (interquartile range [IQR],1-4) and 5 kg (IQR, 4-6), respectively; while in children ≥ 1 year of age (n = 38), these were 4 years (IQR, 2-8) and 17 kg (IQR, 12-23), respectively. On the study day, 19 infants (56%) and 19 children aged ≥ 1 year (50%) received maintenance fluids. Infants received a median of 23 mL/kg (IQR, 12-45) of maintenance fluid in addition to 51 mL/kg (IQR, 40-72) of fluid and nutrition from other sources; maintenance fluids contributed 29% (IQR, 13%-60%) of the total daily fluid intake. Children ≥ 1 year of age received a median of 18 mL/kg (IQR, 9-37) of maintenance fluid in addition to 39 mL/kg (IQR, 25-53) of fluid and nutrition from other sources; maintenance fluids contributed 33% (IQR, 17%-69%) of the total daily fluid intake. When compared with similar data from 2011, there was no change in the amount of maintenance fluid given, which was administered mostly as isotonic fluids.

CONCLUSION: Maintenance fluid contributes about a third of total fluid administration in children in Australian and New Zealand PICUs and is mostly administered as isotonic solutions.